The efficacy and safety of benznidazole in adults with seropositive indeterminate form, Trypanosoma cruzi infection: a systematic review and meta-analysis
Abstract
BACKGROUND: Chagas disease (CD)-a parasitic infection caused by Trypanosoma cruzi, affects ~7 million people worldwide. Current first line therapies like Benznidazole and Nifurtimox have significant side effects, and limited data to support their efficacy when used to treat CD in its chronic indeterminate (asymptomatic) phase. This study aimed to critically assess and meta-analyze all clinical trials to date that address this specific phase of CD. METHODS: PubMed, Cochrane, ClinicalTrials.gov, EBSCOhost, and SciELO (inception - December 2024) were searched for randomized, controlled trials (RCTs) including the efficacy or safety of treatment in adults with indeterminate form, chronic CD. English abstracts were required, with full text in English, Spanish or Portuguese. Studies had to have the potential to report disease progression (primary) or parasitological cure and adverse events (secondary) by treatment regimen. We define parasitological cure as T. cruziPCR negativity. Meta-analysis was conducted using random effects models with inverse-variance weighting of study-specific risk ratios (95% CI). Publication bias was assessed via funnel plots. RESULTS: Five out of 132 studies were unique RCTs that met the inclusion criteria. Inter-rater agreement on study selection was high (κ=0.83). Of all participants, most were female (428/653 or 66%). Summary estimates revealed significant benefit for achieving parasitological cure in treatment versus control groups (overall RR 5.93…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 7 participants or records.
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